Most Relevant Information
Provider Data
| NPI Number: | 1003414269 |
| Provider Name: | CARLEE NICOLE DEMORE |
| Entity Type: | Individual |
| Taxonomy Code: | 225700000X |
| Specialty: | Massage Therapist |
| License Number: | 25954 |
Most Important Dates
| Enumeration Date: | 10/10/2020 |
| Last Updated: | 10/10/2020 |
Provider Practice Location
56880 VENTURE LN # 215S
SUNRIVER
OR
977072158
Practice Location Phone/Fax
| Phone: | 5414200644 |
| Fax: |
Provider Mailing Location
56880 VENTURE LN # 215S
SUNRIVER
OR
977072158
Provider Mailing Phone/Fax
| Phone: | 5414200644 |
| Fax: |